Please note this list is not all inclusive; refer to your plan documents in Workday for a full description. The charts below provide an overview of the dental plan offered to you:
| PLAN DESIGN | Option 1: Low Plan | Option 2: High Plan |
Annual Maximum Benefit
(Calendar Year) | $1,750 | $1,750 |
Deductible (Individual / Family)
(Waived for Diagnostic & Preventive Procedures) | $50 / $150 | $50 / $150 |
Diagnostic and Preventive Procedures
Oral Examinations, Cleanings, Fluoride Treatments, X-Rays, Sealants | 100% | 100% |
Basic Procedures
Fillings, Simple Surgical Extractions, Periodontal Services, General Anesthesia & I.V. Sedation | 100% | 80% |
Major Procedures
Crowns, Bridges, Dentures, Implants, Endodontic Services (Root Canal & Crown Repairs) | 60% | 50% |
Orthodontic Services
(Child Only) | 50% | 50% |
| Out-of-Network | You pay the difference between the negotiated network fee and what the dentist charges | 90th Percentile |
| Note: non-network dental care is reimbursed at usual/customary rates. Patient is responsible for balance. |
To find if your dentist participates in the MetLife network go to www.metlife.com/dental; Network name: PDP Plus; Customer Service # 800-942-0854 Group #05930842
Click HERE to learn how to register on MyBenefits.
Click HERE to view more dental information through the MetLife Mobile App.
Click HERE for more information on the PDP Plus Network MetLife Preferred Dentist Program.
